A nurse on a hospice unit is caring for a client who has cancer and is in the active phase of dying. Which of the following findings requires intervention by the nurse?

An assistive personnel is encouraging intake of oral fluids.

Supplemental oxygen is in use.

Benzodiazepines are administered every 4 hr.

A family member remains at the client's bedside 24 hr each day.

Answer and Explanation

The Correct Answer is A

A. An assistive personnel is encouraging intake of oral fluids: For a client in the active dying phase, forcing or encouraging oral intake can cause discomfort, aspiration, or fluid overload. The focus should be on comfort rather than meeting standard hydration goals, so this requires intervention by the nurse.

B. Supplemental oxygen is in use: Oxygen may be provided for comfort if the client experiences dyspnea. Its use in the active dying phase is appropriate and does not require intervention unless it causes discomfort or is unnecessary.

C. Benzodiazepines are administered every 4 hr: Scheduled benzodiazepines can help manage anxiety, restlessness, or dyspnea in a dying client. This is an appropriate intervention for comfort and does not require nurse intervention.

D. A family member remains at the client's bedside 24 hr each day: Continuous presence of family provides emotional support and comfort for both the client and loved ones. This is consistent with hospice care principles and does not require nurse intervention.

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Correct Answer is B

Explanation

A. "Your baby is at a higher risk because they have had four bowel movements in the first day of life.": Frequent bowel movements in a newborn typically help excrete bilirubin and reduce the risk of jaundice. Therefore, having multiple stools on the first day is actually protective rather than a risk factor.

B. “This is because your baby's liver is not yet efficient at breaking down red blood cells.”: Newborns naturally have an immature liver that is less efficient at conjugating and excreting bilirubin. This leads to an accumulation of unconjugated bilirubin in the blood, making a serum bilirubin test necessary to monitor for jaundice.

C. "This is because your baby is breastfed. You should start supplementing with formula.": Breastfeeding alone is not a contraindication nor an immediate reason to supplement. Breastfeeding jaundice can occur in some infants, but formula supplementation is not automatically required and should be based on assessment by the provider.

D. “Your baby is at a higher risk because they were born with congenital dermal melanocytosis.”: Congenital dermal melanocytosis (Mongolian spots) is a benign skin pigmentation and does not affect bilirubin metabolism.

A. Preoccupied with details B. Perfection C. Suspicious of others D. Highly critical of self E. Exploitative

Correct Answer is ["A","B","D"]

Explanation

A. Preoccupied with details: Clients with obsessive-compulsive personality disorder (OCPD) often focus excessively on rules, order, and minor details, which can interfere with task completion. This rigidity is a hallmark feature of the disorder.

B. Perfection: A strong need for perfectionism is characteristic of OCPD. Clients set unrealistically high standards for themselves and others, often leading to frustration and impaired functioning when these standards are not met.

C. Suspicious of others: Suspiciousness is more characteristic of paranoid personality disorder, not OCPD. Clients with OCPD are typically preoccupied with order and control rather than distrust of others’ motives.

D. Highly critical of self: Clients with OCPD tend to be self-critical and overly focused on flaws or mistakes, which reinforces rigid behaviors and perfectionistic tendencies.

E. Exploitative: Exploitative behavior is more characteristic of antisocial personality disorder. Clients with OCPD are generally rule-bound and conscientious rather than taking advantage of others for personal gain.

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A nurse on a hospice unit is caring for a client who has cancer and is in the active phase of dying. Which of the following findings requires intervention by the nurse?

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